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Articles

Probationary Periods
by Elspeth Buck 3rd July 2013

With so many new appointments now being subject to the successful completion of a probationary period and so many questions coming into the First Practice Management advice line asking how to safely dismiss someone on a probationary period I felt that some guidance on probationary periods would be helpful.

There is substantial evidence to suggest that probationary periods increase the probability that new employees will succeed in their new roles. The purpose of a probationary period is to allow a specific time period for the employee and employer to assess suitability of the role after having firsthand experience.

The Secret Diary of a Practice Manager Part 5
by Anonymous Blogger 3rd July 2013

June was full of activity and it highlighted once again the scope of work we practice managers have to undertake.

It all started with the second part of Calculating Quality Reporting Service (CQRS) training on Monday. 50 people were booked into the online session but only 38 managed to sign in. Like last week’s part one training it was affected by technical issues with modules not working. In the end so little was really gained from the training session we only received an overview. However I think if it works better than the demo it will be of benefit and a trail of income can be followed. I hope my optimism is rewarded.

Digital Dictation or Voice Recognition?
by The Microphone 3rd July 2013

Last week, a GP shared his experience on the blogosphere in a post titled “How I improved the accuracy of our digital dictation software”. Great title that keeps you wanting more, except for the fact that:

a) You can’t improve the accuracy of a digital dictation. It just works.

b) The only thing you can improve is the accuracy of your voice recognition system, which is what this brave GP did. And I say “brave” because from what I could read, it wasn’t a small job.

What are your thoughts on the health tourism debate?
by First Practice Management 3rd July 2013

Will a £200 upfront fee really cover the cost of expensive treatments such as HIV, cancer, midwifery and antenatal care? Should GPs do the policing in addition to their existing workload? If not, why should other professions in other industries such as Human Resources be responsible for immigration policing?

Or is this all simply a great big mess about to get messier?

We’re interested in hearing your views on this and the effects it has had on your practice. Please get in touch via the blog.

Keeping up staff morale when making cuts
by Elspeth Buck 19th June 2013

Sometimes, Practice Managers have to undertake the difficult job of making cuts in staff hours and numbers for reasons such as shrinking profit. However, is there a way to go about this without falling foul of employment law or damaging staff morale?

Changes following a financial review could require the decision of reducing staff hours or in some cases, reducing the number of staff altogether.

To be or not to be a managing partner?
by Jeffrey Krell 19th June 2013

Having worked in my present surgery for 8 over years as Practice Manager I have just become a Managing Partner as of April 1st 2013. In this article I hope to put over how and why we reached this decision and the things to consider if you are asked to become a partner.

It is now becoming more popular for managers to be partners.

There are many reasons for this development. Doctors came into the profession to look after their patients and not to handle the increasing paperwork, nor to manage the constant changes that successive governments seem to impose.

Exclusive Interview with a Practice Manager who has had their CQC inspection.
by Keerti Baker 12th June 2013

It has been a couple of months since GP Practices had to register with the Care Quality Commission (CQC) and inspections are already underway.

Milehouse Medical Practice was inspected this April and First Practice Management has spoken with Christine Sweeney, Practice Manager at Milehouse to find out more about what exactly happens in a GP Practice CQC inspection.

You might remember my earlier concept of the “DoH bright spark thinking man” - that recurrent and unknown genius in the political machine who controls Jeremy Hunt with his right fore-arm.

The latest wonder emerging from the corridors of power is for EVERY DoH civil servant to each spend a month every year in the NHS “front line”. I bet they are thrilled with the idea. After all, is it in their job description? I think not. I would be surprised if the unions overlook this one.

What the Law says about Work Related Stress
by Elspeth Buck 5th June 2013

As an employer you have a legal obligation to try to identify any problems that your organisation might be having with work related stress.

Health and Safety legislation requires that if an employee is feeling under stress due to work/work environment, the employer must take steps to rectify the situation where possible.

As an employer you do however have the right to expect that an employee is able to cope with the “normal” pressures of the job. There are a number of factors that will help determine what should be done next. The following steps are advisable, ensuring all meetings and other aspects are fully documented.

The Secret Diary of a Practice Manager Part 3
by an Anonymous Practice Manager 29th May 2013

This blog highlights the very varied role we take as practice managers.

It isn't all about form filling and target chasing.

Well here I am Bank holiday Monday and contemplating the week ahead, and thinking of the past week. The terrible events of Wednesday in Woolwich took away the government’s much trumpeted latest NHS change the next day. I decided to read on line, Jeremy Hunt’s speech and if it had been given major coverage it was still in my opinion a lot of hot air and no substance. Nothing new there then?

There has been much recent publicity about A&E’s being unable to cope with the demand on its services for which many are blaming GP's because they do not provide their own out of hours cover.

Recently on the radio 5 breakfast show a professor in emergency medicine and a foundation trust chief executive placed the blame firmly on the GP Contract!

The Health Secretary Jeremy Hunt acknowledged A&E units were "under great pressure" and said a major factor in the rise in A&E attendances was the "disastrous changes" to the GP contract, which allowed them to opt out of providing out-of-hours care.

First Practice Management is pleased to provide facilitation services for practices in all areas of the country.

Most practices organise occasional partners’ away days, strategic planning days and all-practice team building sessions. We believe these events are most successful when run by an external facilitator, allowing the practice manager to participate fully rather than worrying about the process. Our facilitators are very experienced and understand the issues facing general practice. They will work with you to plan the process to ensure your desired outcomes are clearly understood. They will then run the sessions, handle any areas of conflict, keep the group on track, ensure action points are agreed and the desired outcomes are achieved.

What constitutes good management? Keeping things going without major incident or developing your practice to meet future challenges. For many practice managers, their job is a mixture of both. They are required to take a very hands- on day to day role in ensuring that things run smoothly and also take on responsibility for developing the practice business for the future.

The thought of practice development planning is sometimes a luxury that takes second place t immediate management activities but is really a vital part of preparing for the future that practices face. For many managers external change puts a huge amount of pressure on the day to day work – but this is often when it is most crucial to devote time to planning.

Where Do You Start When Recruiting a GP Practice Receptionist?
by Ruth Long 14th May 2013

On first glance, and perhaps to people external to the industry, it might seem that a GP practice’s receptionist is no different to a receptionist working in the hospitality or corporate industry environment.

However, the reality is that a GP Practice is a very different environment, and when it comes to recruiting receptionists for your GP practice “you can never judge a book by its cover” is the line of thinking adopted by First Practice Management’s General Manager Ruth Long.

Integrity - dead, or just out of fashion?
by Steve Morris 8th May 2013

Thankfully fraud by practice managers is unusual, but another major incident in Manchester, resulting in a jail sentence, highlights just how much the partners have to rely on the integrity of their staff and management.

That is not to say however that there is some invisible line that managers draw, or partners do not cross, without demonstrating a lack of faith.

Car parks are outside the building (usually) and so under come under the spotlight twice a day, and one of these times is when you are leaving! So what are the issues?

Car parks, or more precisely cars, are a major workplace hazard and as managers you have an H&S responsibility to ensure that users of your premises, including car parks, can do so on a safe and protected basis.

An Introduction to Social Media for GP Practices
by Liam Cowling 1st May2013

It’s an interesting question. The NHS and GP Practices are now expanding into the social media sphere.

I know the glitz and glamour of social media marketing is appealing with all the retweets, hash tags, shares, news and instant celeb gossip. It can’t be helped - we all want to know what our favourite celebrity is eating for dinner or who our ex is now dating. But what it really drills down to is “How will my practice use it?”

There are a huge amount of pressures on practice managers at present – CQC, New QOF , loss of the PCT and all the support they gave and getting to grips with how the new CCGs will impact upon the practice. The ability to motivate, influence and get people on board with changes is a skill they need to acquire very quickly in order to survive in the new world. The ability to influence others quickly and effectively will be invaluable in moving things forward.

As you will have heard, there is an outbreak of measles in South Wales, centred on the Swansea area. Since the outbreak occurred in November, the total number of reported cases has now passed 800 and the first death as a result of suspected measles has occurred.

Keep Calm it's Only a CQC Inspection
by Kate Hodkinson 17th April 2013

What happens when you get the dreaded phone call giving you 48 hours notice of a CQC inspection?

Firstly – don’t panic! Evidence from the pilot visits and dental practices shows that the CQC inspectors are mostly normal people who just want to do their job well and that they have taken a reasonable approach to practices where they can’t quite put their hands on the evidence at the time.

First Practice Management hosted a packed session at the Imperial War museum in Manchester with the aim of helping managers to prepare for the CQC Visit – which could happen this month – or might not take place for another two years. The event provided managers with an opportunity to focus on what would actually happen at an inspection visit and how to prepare their practice and the team. Plus download the presentation for that event. Also keep your eyes peeled for the FPM CQC Roadshow video.

Can an employer dismiss an employee due to long term sickness?
by Elspeth Buck 10th April 2013

Employers are not expected to keep a sick employee’s job open indefinitely, however it is necessary to follow a fair procedure to manage a long term absence situation. If you proceed towards a dismissal you will potentially have to show that the dismissal was justified and fair after properly exploring all the options open to you.

Mirren Jones is the pseudonym for the creative writing partnership of Marion Duffy and Elaine Atkins. Together they have published two works of non fiction and a new debut novel.

Marion and Elaine are looking for Practice Manager anecdotes for their new novel 'Never Do Harm'. Visit her article on the FPM Blog. The winning anecdote wins a signed copy of Mirren Jones First Novel 'Eight of Cups'

It’s hard to believe that FPM Group is celebrating our 10th anniversary this year. To commemorate the occasion, members of the Group got together and had a celebration with lunch and a delicious cake...

How to cost effectively buy Medical Equipment
FPM Buying Club 3rd April 2013

Top Tips from FPM Buying Club's Nick Coleman and Udhi Silva

During our careers we’ve bought pretty much everything a hospital, surgery or care home would ever need to buy. This has enabled us to grasp a great understanding of how to buy medical equipment in the most cost effective way. Here’s our top tips on how we do it:

Reputable brands - medical equipment must adhere to the appropriate MHRA regulations, therefore always keep in mind that anything you buy will require CE marking. Don’t be fooled by cheap equipment you find on Google as chances are this won’t be acceptable for use in the UK.

No hidden charges – suppliers love to charge for add ons. Whether you need software, cuffs, trolleys, batteries or cables make sure you ask for a list of everything you need so that you can take into account the total cost of the product.

Low maintenance costs - buying the latest state of the art technology may mean only a handful of companies are able to calibrate or maintain it to the required MHRA standards. You need to take into account the full life-cycle cost of the product and factor in the cost of the maintenance charges to understand the true cost...

Phased return to work following long-term sickness absence
by Elspeth Buck 27th March 2013

Question: I have a member of staff who, after being absent for work due to ill health for the past 9 months is now able to return to work. The practice has been in contact with the individual throughout her absence and the individual was referred to an occupational health specialist; who advised a phased return to work over a four week period would help the individual ease back into the role at the practice...

The FPM Blog Website features a wide range of articles, blogs, surveys, regional and legislation updates. We will be covering all aspects of day-to-day practice management, operations, development, finance, compliance, HR, CQC, QOF and any other topic that affects the management of a GP practice.

The FPM Blog Website is mobile ready, so whether you are sat at your Desktop PC or out and about you can easily access a version of the FPM Blog to suit your device...

The DWP (Department of Work and Pensions) state that currently only 10 per cent of employees in small organisations have access to an occupational health service, compared with more than half of employees in large organisations. The government has announced a new health advice service will be introduced to help reduce sickness absence in the work place...

The new initiative will ensure employees receive a bespoke, independent advice for cases of sickness absence lasting more than four weeks...

From 1 April 2013 all providers of NHS general practice and other primary medical services must be registered with the Care Quality Commission (CQC). If you are a practice manager/practice staff member and would like to find out more about how you can implement changes through your practice(s), this FPM CQC Roadshow is for you.

This one-day event is invitation-only and we have invited speakers from related industries with direct inspection experience to share their experiences of what happens in a CQC inspection and how they have dealt with it. The event will also discuss how practice managers can engage with staff and help them adopt CQC changes.

First Practice Management are pleased to announce the relaunch of the FPM Buying Club. We have teamed up with Medical Supermarket to offer lower cost equipment, supplies and services to our member practices. The new deal will give thousands of FPM members access to more than 60,000 discounted products and services via the dedicated FPM Buying Club Wesbite.

In addition to pricing, the FPM Buying Club offers a convenient way for GP practices to shop online. Customers can choose between thousands of products and receive just one invoice. The FPM Buying Club is completely free to FPM members who can get the best deals on all products and services straight away...

CQC has recently published a guide for GP practices to help prepare for inspections that will take place after 1st April 2013.The guidance clarified certain aspects of the visit and what will happen and will help practices to prepare.

The guidance confirms that they are particularly interested in the experience of the services users – they will check the information that they receive from the patients through a variety of sources in the practices. This emphasis means that practices will need to make their patients aware of the possibility of a visit and certainly inform patients who will be attending appointments of a CQC visit day...

Are you a stifled wordsmith with something to say about practice management? Do you fancy sharing it with your fellow primary care managers and practice colleagues across the UK? We want to hear your opinions on the issues of the day, your practice success stories and even your cautionary tales.

We are about to launch FPM Blog - an extension of the main First Practice Management website. The FPM Blog website will...

Does your website help you with CQC compliance?
by Steve Morris 6th March 2013

An alternative view of patient web communications

I think it is accurate to say that nearly all practices now have a website presence. After all, your patients expect this. The range is vast – from a few basic self-designed pages through the raft of mid-range “off the web” customisable templates, to the primary care specialist design companies and the “bells and whistles” of a fully functional website.

Most look great, but others look washed-out and unloved, the result of an uneasy marriage between an unskilled staff member and a few pages of text a few years ago. How do you expect your patients to interact with a website which looks neglected and still shows a Christmas closure message from 2011?

Does your practice have a strategy? or "Thinking around corners"
by Jeremy Thorn 20th February 2013

EXECUTIVE SUMMARY

‘Strategy’ is a word often abused, but every organisation needs one if it doesn’t want to be a cork bobbing on the ocean of life, and so also may each part of that organisation, to ‘think around the corners’;

Some may feel that they can’t control their outside world so there is no point wasting time strategising. But that may be precisely when having a strategy to cope with such situations may be even more important than ever?

Others may feel that strategy development is not their strength, too remote from their known reality. But some in your team will, so identify them and get them on your team!

Gathering preliminary core data is important, and there are lots of strategic planning tools around to help structure this.

Note that serious strategy development does not happen over-night? – it needs an iterative process of constant refinement. So don’t try to complete this in one go. Take it in digestible chunks as suggested? I offer an overall format that works really well.

Great strategy development may highlight fault-lines in any organisation, however well intentioned. If it does, don’t ignore them but deal with them sensitively. That’s partly what great strategy development should be all about...

FPM and DIane Abbott visit Manchester member practices to work shadow
by Keerti Baker 20th February 2013

First Practice Management (FPM) accompanied Diane Abbott MP, Shadow Minister for Public Health to visit member GP practices in Manchester on Thursday 14th February. This visit was a follow-up from FPM’s interview of Mr Andy Burnham (Shadow Health Secretary) in January 2013. As part of Labour’s health and social care policy review, Labour is visiting practices across the country for work shadowing and First Practice Management assisted by arranging the visit with their practice members. Diane Abbott and First Practice Management visited the Borchardt Medical Centre and Kingsway Medical Practice in Manchester where Diane spoke with staff including GPs and Practice Managers...

This is the first of a series of articles on the management of sickness absence, starting with short-term absence. We will also cover; long-term absence, return to work interviews, occupational health and termination on the grounds of ill health.

According to CIPD (The Chartered Institute of Personnel and Development) two thirds of working time is lost to absence is accounted for by short-term absences of up to seven days.

The most common reasons for short-term absences are minor illnesses such as, colds, flu, stomach upset, headaches and migraines and musculoskeletal back pain.

As the role of the practice manager grows and resources become more scarce, now is the time for everyone to focus on being as efficient and as effective as they can with the time they have available.

A Personal Approach

People are different – the ways in which they think, respond, work and plan are all unique and with that should go a unique way of managing time and workload. There is not one set of rules but many different things that you can pick and choose from. This article will focus on some suggestions that may work for you but is by no means an exhaustive list of all the techniques available.

The current consultation for the proposed contract changes was set out by the DoH in December 2012, and runs until 26 February 2013. The Secretary of State will then consider all the responses and decide on the changes for the contract for 2013/14.

There are a number of key changes being proposed:

Securing equitable funding in GMS contractual arrangements from 2014/15 phased in over a seven year period along with the redistribution of correction factor payments between contractors.

An indicative 1.5% uplift, but also considered in light of any recommendation made by the doctors’ and dentists’ pay review body. This is designed to allow a 1% uplift for staff and GP pay, with the remainder to “more than cover” overhead costs...

First Practice Management exclusively interviewed Andy Burnham MP, Shadow Secretary of State for Health, in London on 16th January 2013.

FPM staff member and trained journalist Keerti Baker, asked Mr. Burnham the "burning questions" put forward by our members. The interview covers a range of topics from specific GP practice issues through to the health service in general, and all from a practice managers’ perspective. Amongst the topics discussed are CQC inspections, treatment of foreign visitors by GPs, CCGs, practice boundary reform, PFI Contracts, GP morale and round-the-clock working, along with his vision for health and social care reform.

According to CIPD (The Chartered Institute of Personnel and Development) the most common causes of long-term sickness absence are stress, acute medical conditions (for example stroke), mental ill health, musculoskeletal injuries and back pain.

Long–term sickness is probably one of the most difficult problems for practices to tackle, and have the potential to result in claims of unfair dismissal or disability discrimination. Which is why it’s no surprise some employers shy away from managing the situation hoping it will sort itself out. Key steps to dealing with long-term absence...

Asbestos in buildings is not something which concerns most practice managers, but should it?

What is required to manage asbestos? Do you know whether your practice premises contain asbestos or not? It was commonly used in buildings from the 1950s through to the mid-1980s, but any building built up to around 2000 can have asbestos in it. Do you know whether you should be managing this, whether someone else should be, or whether you should be informed of the asbestos status or the building by someone else? You need to find out...

One of the partners is very keen on introducing business plans but others of us are not persuaded that we need this. Can you offer any advice?

Not an uncommon scenario in general practice. In my view the answer is “any practice should now have an up-to-date business plan”. In much of the recruitment work we do one of the questions asked by a prospective candidate is “Do you have a business plan” or “What’s in your business plan?”...

Does your website help you to comply?
by Steve Morris 19th December 2012

General practice websites are a mixed bag, varying from a web presence updated only occasionally and when forced to go so by radical change, through to an on-line tool providing a portal for patients to interact with the practice, other patients, and the staff managed daily.

There is still a lingering culture in some practices which keeps the patient at arms’ length, restricting communication to the tried and tested GP / nurse consultation. This of course is a comfort zone, supported by a myriad of protocols and procedures designed to capture information, record accurately, and not lose essential information. But what happens to those practices forced to move outside this protective rim, and embrace the concepts of patient involvement, interaction and care when they have no track record of developing this approach gradually over the last year or so? Satisfying the requirements of the CQC and QOF where more than just lip-service is needed may for them be a step too far...

With temperatures dropping over the coming weeks employees across the UK may be faced with difficulties getting into work. This article looks at common concerns raised by managers when staff are unable to attend work due to the weather...

Air Conditioning: Stay legal and reduce your costs with a service contractby ACS 10th December 2012

There are some legal stipulations on having air conditioning equipment serviced and maintained. One important pieces of legislation relates to the F-Gas regulations. Any air conditioning systems with a refrigerant charge of over 3kg (which means approx 90% of air con units) have to be, by law, compliant with the F-Gas regulations, as set out by EC regulation 842/2006. The F-Gas laws are primarily aimed at our customers to ensure they minimise the risks of refrigerant gas leakage by making sure they regularly leak test ....

Performance appraisal has become common practice in most GP surgeries over recent years for a variety of reasons.

Some use it to focus their training plans and spend their training budget wisely; some use it to help achieve the practices’ objectives in a more strategic fashion; some carry out appraisals as a way of motivating and engaging the team and there are some practices that do it for QOF points and get very little in the way of benefits in return for their investment. I feel that there are two main ways in which appraisal can be beneficial to an organisation...

FPM’s Steve Morris looks at Practice Manager packaging... (which is not the box they came in)

Here at FPM we have been involved in Practice Manager remuneration one way or another for many years. In our recruitment work with practices, on our advice line and from Practice Managers directly, we handle a stream of questions about the appropriate remuneration level for a Practice Manager – both new and existing. Since 2005 the data supporting our annual practice managers’ salary survey is comprehensive and precise, with many managers writing to us to say that they have successfully negotiated better packages based on our figures...

We are pleased to announce that Towergate Financial is now working in partnership with First Practice Management to provide our members with exclusive financial services and products. Towergate Financial is a leading UK provider of financial advice who can offer you products from the whole of the market, not just the ones that are offered on the high street. Focusing on your individual needs and circumstances Towergate Financial will work with you to create a tailored investment and retirement plan. As part of the Towergate Financial Group, you will also gain access to the services and products at John Charcol, a leading provider of award winning independent mortgage advice, and Health+, a leading provider of bespoke health insurance and solutions...

The lack of definitive guidance on Chaperones in general practice has resulted in a wide variation across practices in the way they identify the need for a chaperone and how any policy is implemented. The requirement for Registration with the Care Quality Commission is putting pressure on practices to begin managing the issues of chaperones more carefully. There are several ways in which Chaperoning would support compliance with CQC...

Induction for the Newly Appointed Practice Manager
by Steve Morris 7th November 2012

New to your role? Steve Morris, once a newly appointed Practice Manager himself, provides some hints and tips. If this is your first appointment as a Practice Manager and if, like many other new appointments to this role, you have had no experience to the NHS then welcome to general practice! Many practices are appointing managers with little or no experience of the NHS, but with plenty of transferable skills and experience of managing people, finance and computers and the like. You join a growing group of people in the UK joining general practice from outside the NHS, who are embarking on a vertical learning curve. These notes contain some suggestions about what you might do to find your feet...

First Practice Management welcomes Supplies Team Solutions7th November 2012

First Practice Management is pleased to announce that we are now working in partnership with procurement specialists, Supplies Team Solutions. As a division of the multi channel distributor, Vasanta Group, Supplies Team Solutions is one of the largest providers of business supplies and solutions in the UK. Their innovative approach to procurement allows you to consolidate your supply chain in order to reduce time and money spent when sourcing your business supplies and services. Supplies Team Solutions’ extensive range of 25,000 business products and services includes; Electronic office supplies, Stationery, Hardware, Catering and janitorial, Office interiors, Managed print, Corporate gifts, Facilities management, and much more!

Worried about Real Time Information (RTI)? Want to know more about PAYE, SSP, and all that? NHS Pension Scheme issues to deal with (‘Constructed Values’, Retirements, etc.)? PayeDoc, the specialist Payroll Agency for GP Practices, is providing a series of seminars to address all these issues and more...

Q: "I recently advertised the role of receptionist and we had a number of external applicants who submitted an application form for the role. The head receptionist and I have now interviewed five candidates and made a verbal offer of employment to one individual who has all relevant skills ....?"

Being a Practice Manager – Having a Mentor
by Steve Morris 24th October 2012

Mentoring has its origins in Greek mythology. When Odysseus, father of Telemachus, went off to the Trojan War he appointed Mentor to be his son's guardian, role model, adviser, confidant and friend. Mentor was responsible for the physical, intellectual, spiritual, moral and social development of Telemachus. Mentoring is a "win, win, win" situation as the protégé, the mentor and the organisation (in this case the medical practice) all benefit from the potential that mentoring can realise in them all...

It is well known that space in General Practice has always been at a premium. In 2006 the GPC premises survey showed most GP premises were of high quality and purpose built, but no longer had sufficient space ....

You may remember back in 2009/ 2010, all parts of the NHS and other organisations who provide services to children and vulnerable adults were preparing for the implementation of major new regulations relating to working and safeguarding. It appeared the a very complex ....

Q: "I recently became practice manager and, unfortunately, I have noticed that there are a number of discrepancies between individual salaries at the practice. The discrepancies are not only between one role to the next but also between individuals performing the same role. I am keen for staff to be treated consistently and fairly at the practice and would like some guidance ...."

The need for effective performance management has increased in recent years to the point at which it can no longer be ignored. Poorly motivated staff, delivering second-rate services that don’t meet the needs of patients will not help to meet the CQC Essential Standards of Quality and Safety nor make any practice the first choice for patients when ....